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精神药物对下丘脑 - 垂体 - 肾上腺调节的影响。

Effects of psychotropic medications on hypothalamic-pituitary-adrenal regulation.

作者信息

Meador-Woodruff J H, Greden J F

机构信息

Department of Psychiatry, University of Michigan, Ann Arbor.

出版信息

Endocrinol Metab Clin North Am. 1988 Mar;17(1):225-34.

PMID:2897911
Abstract

The psychotropic medications reviewed in this paper have widespread clinical applicability in psychiatry and other branches of medicine. These drugs clearly can alter peripheral regulation of hypothalamic-pituitary-adrenal axis hormones. In general, psychotropic medications when administered acutely have a tendency to increase the output of both adrenal and pituitary hormones associated with the axis; the benzodiazepines appear to be the exception and indeed may decrease axis activity. Psychotropic agents may also alter the results of the dexamethasone suppression test as currently used in psychiatry, since they alter the neurotransmitters that regulate corticotropin-releasing hormone secretion and also because they may change the severity of the underlying pathophysiology. Withdrawal of these drugs after long-term administration may cause an elevation of these hormones, potentially increasing the false-positive rate of the dexamethasone suppression test and other neuroendocrine tests.

摘要

本文所综述的精神药物在精神病学及医学其他分支领域具有广泛的临床适用性。这些药物显然能够改变下丘脑 - 垂体 - 肾上腺轴激素的外周调节。一般而言,精神药物急性给药时往往会增加与该轴相关的肾上腺和垂体激素的分泌量;苯二氮䓬类药物似乎是个例外,实际上可能会降低轴的活性。精神药物还可能改变目前在精神病学中使用的地塞米松抑制试验的结果,这是因为它们会改变调节促肾上腺皮质激素释放激素分泌的神经递质,还因为它们可能改变潜在病理生理学的严重程度。长期服用这些药物后停药可能会导致这些激素水平升高,从而可能增加地塞米松抑制试验及其他神经内分泌试验的假阳性率。

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